摘要
目的研究高频重复经颅磁刺激(rTMS)治疗帕金森病(PD)认知功能障碍的效果。方法选取2020年3月至2022年2月聊城市第四人民医院神经内科门诊及住院患者中的120例PD患者作为研究对象,按照随机数字表法分为研究组与对照组,各60例,在研究中因其他原因有8例患者先后退出,最终有112例患者完成整个研究过程,研究组和对照组各56例。研究组采用高频rTMS(25 Hz)真性刺激治疗,对照组采用高频rTMS(25 Hz)假性刺激治疗,靶点均为右侧前额叶背外侧区,分别在治疗前,治疗后即刻,治疗后1、2、3个月对两组患者进行简易精神状态检查量表(MMSE)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、蒙特利尔认知评估量表(MoCA)评分及P300检测的评定,对两组患者的认知功能进行评价。结果治疗后即刻及治疗后1、2个月,研究组MMSE、MoCA量表评分高于本组治疗前,HAMA、HAMD评分低于本组治疗前,P300潜伏期(PL)短于本组治疗前,波幅(Amp)高于本组治疗前,差异有统计学意义(P<0.05)。治疗后3个月,研究组各指标与本组治疗前比较,差异无统计学意义(P>0.05)。治疗后即刻,治疗后1、2、3个月,对照组各指标与本组治疗前比较,差异无统计学意义(P>0.05)。治疗后即刻,治疗后1、2个月,研究组MMSE、MoCA量表评分均高于对照组,HAMA、HAMD量表评分均低于对照组,PL低于对照组,Amp高于对照组,差异有统计学意义(P<0.05)。治疗后3个月,两组患者MMSE、MoCA、HAMA、HAMD量表评分、PL与Amp值比较,差异无统计学意义(P>0.05)。结论高频rTMS治疗可明显改善PD患者的认知功能障碍,且疗效可维持到治疗后2个月。
Objective To investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation(rTMS)in the treatment of cognitive dysfunction in Parkinson's disease(PD).Methods A total of 120 PD patients from March 2020 to February 2022 in the Department of Neurology of Liaocheng Fourth People's Hospital were selected as the study subjects,and they were divided into the study group and the control group according to the random number table method,with 60 cases in each group.Eight patients successively withdrew due to other reasons in the study,and 112 patients finally completed the whole study process,with 56 cases in the study group and 56 cases in the control group.The study group was treated with high-frequency rTMS(25 Hz)authentic stimulation,while the control group was treated with high-frequency rTMS(25 Hz)pseudo stimulation.The target sites were all in the dorsolateral prefrontal region of the right prefrontal lobe.The two groups of patients were administered the mini-mental status examination(MMSE),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD).The cognitive function of the two groups of patients was evaluated by the Montreal cognitive assessment(MoCA)score and P300 test.Results Immediately after treatment and 1,2 months after treatment,the scores of MMSE and MoCA in the study group were higher than those before treatment,while the scores of HAMA and HAMD were lower than those before treatment,with statistically significant differences(P<0.05).The P300 latency(PL)was shorter than that before treatment,and the amplitude(Amp)was higher than that before treatment in the study group,with statistically significant differences(P<0.05).Three months after treatment,there were no statistically significant differences in these indexes of study group compared with those before treatment(P>0.05).Immediately after treatment and 1,2,and 3 months after treatment,there were no statistically significant differences in these indexes of control group compared with those before treatment(P>0.05).Immediately after treatment and 1,2 months after treatment,the scores of MMSE and MoCA in the study group were higher than those in the control group,while the scores of HAMA and HAMD were lower than those in the control group,PL was lower than that in the control group,and Amp was higher than that in the control group,with statistically significant differences(P<0.05).Three months after treatment,there were no statistically significant differences between the two groups in MMSE,MoCA,HAMA,HAMD scores,PL and Amp values(P>0.05).Conclusion High-frequency rTMS treatment can significantly improve cognitive dysfunction in patients with PD,and the efficacy can be maintained until 2 months after treatment.
作者
杨明健
YANG Mingjian(Department of Neurology,Liaocheng Fourth People's Hospital,Shandong Province,Liaocheng252000,China)
出处
《中国当代医药》
CAS
2023年第12期19-24,共6页
China Modern Medicine
关键词
帕金森病
认知功能障碍
重复经颅磁刺激
治疗
Parkinson's disease
Cognitive dysfunction
Repetitive transcranial magnetic stimulation
Treatment
